The LA Times has a write-up today about the Bush administrations proposed conscience rule and its breadth. David Savage explains,

The outgoing Bush administration is
planning to announce a broad new "right of conscience" rule permitting
medical facilities, doctors, nurses, pharmacists and other healthcare
workers to refuse to participate in any procedure they find morally
objectionable, including abortion and possibly even artificial
insemination and birth control.

For
more than 30 years, federal law has dictated that doctors and nurses
may refuse to perform abortions. The new rule would go further by
making clear that healthcare workers also may refuse to provide information or advice to patients who might want an abortion. It also seeks to cover more employees. For
example, in addition to a surgeon and a nurse in an operating room, the
rule would extend to "an employee whose task it is to clean the
instruments," the draft rule said.

The "conscience" rule could set the stage for an abortion controversy in the early months of Barack Obama's administration. During
the campaign, President-elect Obama sought to find a middle ground on
the issue. He said there is a "moral dimension to abortion" that cannot
be ignored, but he also promised to protect the rights of women who
seek abortion. While the rule could eventually be overturned by
the new administration, the process might open a wound that could take
months of wrangling to close again.

Despite
the controversy, HHS Secretary Mike Leavitt said he intends to issue
the rule as a final regulation before the Obama administration takes
office, to protect the moral conscience of persons in the healthcare
industry. Abortion-rights advocates are just as insistent that the
rights of a patient come first. If the regulation is issued
before Dec. 20, it will be final when the new administration takes
office, HHS officials say. Overturning it would require publishing a
proposed new rule for public comment and then waiting months to accept
comments before drafting a final rule. . . .

The HHS proposal has set off a sharp debate about medical ethics and the duties of healthcare workers. Last
year, the American College of Obstetrics and Gynecology said a
"patient's well-being must be paramount" when a conflict arises over a
medical professional's beliefs. In calling for limits on “conscientious refusals,”
ACOG cited four recent examples. In Texas, a pharmacist rejected a rape
victim's prescription for emergency contraception. In Virginia, a
42-year-old mother of two became pregnant after being refused emergency
contraception. In California, a physician refused to perform artificial
insemination for a lesbian couple. (In August, the California Supreme
Court ruled that this refusal amounted to illegal discrimination based
on sexual orientation.) And in Nebraska, a 19-year-old with a
life-threatening embolism was refused an early abortion at a
religiously affiliated hospital.

"Although respect for
conscience is important, conscientious refusals should be limited if
they constitute an imposition of religious or moral beliefs on patients
[or] negatively affect a patient's health," ACOG's Committee on Ethics
said. It also said physicians have a "duty to refer patients in a
timely manner to other providers if they do not feel that they can in
conscience provide the standard reproductive services that patients
request." . . .

Judith Waxman, a lawyer
for the National Women's Law Center, said Leavitt's office has extended
the law far beyond what was understood. "This goes way beyond
abortion," she said. It could reach disputes over contraception, sperm
donations and end-of-life care. "This kind of rule could wreak
havoc in a hospital if any employee can declare they are not willing to
do certain parts of their job," she said.